Blog Elements – Page 32 – Trauma International

Half Sized Blog Element (Single Author Style)

Half Sized Blog Element (Multi Author Style)

Triage in Mass Casualty Incidents: Our Preparedness and Response – A Cross-sectional Study from a Tertiary Care Hospital, Karachi, Pakistan

September 10, 2018/in Volume 4 | Issue 2 | Sep-Dec 2018

Vol 4 | Issue 2 | Sept-Dec 2018 | page: 6-10 | Muhammad Qasim Ali, Muhammad Muzzammil, Zehra Batool, Muhammad Saeed Minhas doi- 10.13107/ti.2018.v04i02.068 Author: Muhammad Qasim Ali [1], Muhammad Muzzammil [2], Zehra Batool [3], Muhammad Saeed Minhas [2]. [1] Intern MBBS, Orthopedics ward 17, Jinnah Postgraduate Medical Centre, Karachi, Pakistan, [2] Department of Orthopedics Ward […]

A Prospective Study of Surgical Management of Bimalleolar Fractures with Various Modalities

September 10, 2018/in Volume 4 | Issue 2 | Sep-Dec 2018

Vol 4 | Issue 2 | Sept-Dec 2018 | page: 2-5 | Nandkishor B. Goyal, Sayyadshadab S. Jafri, Ashish Vinayak Patil, Aashish Babanrao Ghodke. doi- 10.13107/ti.2018.v04i02.067 Author: Nandkishor B. Goyal [1], Sayyadshadab S. Jafri [1], Ashish Vinayak Patil [1], Aashish Babanrao Ghodke [1]. [1] Department of Orthopaedics, ACPMMC Dhule. Address of Correspondence Dr. Nandkishor B. Goyal, […]

Triage in Mass Casualty Incidents: Our Preparedness and Response – A Cross-sectional Study from a Tertiary Care Hospital, Karachi, Pakistan

September 10, 2018/in Volume 4 | Issue 2 | Sep-Dec 2018

A Prospective Study of Surgical Management of Bimalleolar Fractures with Various Modalities

September 10, 2018/in Volume 4 | Issue 2 | Sep-Dec 2018

Full Sized Blog Element (Big Preview Pic)

Triage in Mass Casualty Incidents: Our Preparedness and Response – A Cross-sectional Study from a Tertiary Care Hospital, Karachi, Pakistan

September 10, 2018/in Volume 4 | Issue 2 | Sep-Dec 2018

Vol 4 | Issue 2 | Sept-Dec 2018 | page: 6-10 | Muhammad Qasim Ali, Muhammad Muzzammil, Zehra Batool, Muhammad Saeed Minhas

doi- 10.13107/ti.2018.v04i02.068

Author: Muhammad Qasim Ali [1], Muhammad Muzzammil [2], Zehra Batool [3], Muhammad Saeed Minhas [2].

[1] Intern MBBS, Orthopedics ward 17, Jinnah Postgraduate Medical Centre, Karachi, Pakistan,

[2] Department of Orthopedics Ward 17, Jinnah Postgraduate Medical Centre, Karachi, Pakistan,

[3] Department of Orthopaedics, Medical Student Jinnah Sind Medical University, Karachi, Pakistan.

Address of Correspondence

Dr. Muhammad Qasim Ali,
Orthopedics ward 17, Jinnah Postgraduate Medical Centre, Karachi, Pakistan
Email: m.qasim_ali@hotmail.com

Abstract

Background and Objectives:

Trauma is the major concern of the modern world. The ever-intensifying number of causalities being presented with the scarcity of resources, heavily burdens the emergency departments, which are the fundamental centers of a hospital. For a smooth flow and an efficient ER, implementation of a strong triage system with trained emergency staff personnel remains a dire necessity. The present study is aimed to review the awareness and implication of triage among emergency personnel, to evaluate the preparedness of emergency staff involved in the management of massive trauma casualties and highlight the self-identified deficiencies of the hospital and pre-hospital system.

Methods: A cross-sectional study was conducted to evaluate the preparedness, knowledge, and implication of triage by emergency room personnel at Accident and Emergency Department, Jinnah Postgraduate Medical Center, Karachi. The target population for the survey included casualty medical officers (CMOs), assistant casualty medical officers (ACMOs), nursing staff, and casualty operation theatre staff working in all three shifts morning, evening and night from December 2016 to February 2017.

Results: Of the 126 respondents questioned, 32% had no concept of triage. 70% of the respondents mentioned that they have never witnessed any patient already triaged brought to their ER indicating a poor onsite triage system. Only 23% (n = 29) received any training for triage before in past 5 years. Therefore, 97.61% emphasized the need of refresher training programs. On testing with standard scenarios of triage, it was investigated that 27 out of 126 participants answered all the questions correctly. No training drill or courses had been conducted for disaster management of the surveyed hospital.

Conclusion: Effective and early disposal of patients from accident and emergency needs trained triage team. Thus, it is imperative that training of ER personnel to be conducted as a continuous process. This study finding will be useful for planning future triage awareness programs in the form of classroom courses and hospital drills to curb mass casualties.

Keywords: Triage, Emergency personnel, Trauma, Bomb blast, Mass incidents.

References

1. “Triage.” Merriam-Webster, Merriam-Webster. Available from: http://www.merriam-webster.com/dictionary/triage. Last Accessed date: 21st Feb 2017.

2. Rignault D, Wherry D. And finally: Lessons from the past worth remembering: Larrey and triage. Trauma 1999;1:85-9.

3. Weinerman ER, Ratner RS, Robbins A, Lavenhar MA. Yale studies in ambulatory medical care. V. Determinants of use of hospital emergency services. Am J Public Health Nations Health 1966;56:1037-56.

4. Iserson KV, Moskop JC. Triage in medicine part I: concept, history, and types. Ann Emerg Med 2007;49:275-81.

5. Dahlberg LL, Krug EG. Violence-a global public health problem. In: Krug EG, Dahlberg LL, Mercy GA, Zwi AB, Lozano R, editors. World Report on Violence and Health. Geneva: World Health Organization; 2002. p. 1-20.

6. WHO|Road Traffic Injuries. Available from: http://www.who.int/violence_injury_prevention/road_traffic/en/. Last Accessed on 5thFeb 2017

7. WHO|Injuries and Violence. Available from: http://www.who.int/violence_injury_prevention/key_facts/VIP_k ey_facts.pdf?ua=1. Last Accessed on5thFeb 2017

8. Pakistan Institute of Peace Studies: PIPS Security Report 2016. Available from: https://www.pakpips.com/article/book/pakistansecurity-report-2016 [Last accessed on 2017 25th Jan].

9. Centre for Research and Security Studies: CRSS Annual Security Report 2016. Available from: http://www.crss.pk/wpcontent/uploads/2010/07/Annual-report-2016.pdf. (Last accessed on 25th Jan 2017)

10. Gazder, Uneb & Ahmed, Muhammad & Adnan, Muhammad. (2015). Spatial & Temporal Investigation of Road Accidents in Karachi.

11. Pre-hospital Trauma Life Support. 2nd ed. Patient Assessment and Management. 1990. p. 42.

12. Tanabe PG, Travers DA, Rosenau AM, Eitel DR. Index Emergency
Severity Index. Version 4: Implementation Handbook. A.H.R.Q Publication No. 05 – 00462. Rockville, MD: Agency for Healthcare Research and Quality; 2005.

13. Siddiqui MA, Jawad A, Minhas S, Ansari A, Siddiqui A, Mehtab S. Pakistan: The new target of terrorism. Are Karachi’s emergency medical response systems adequately prepared? J Pak Med Assoc 2009;59:441-5.

14. At Least 17 Die in Karachi Train crash in Pakistan. BBC. 3 November 2016. Available from url : https://www.bbc.com/news/world-asia-37856299 [Last accessed on 2016 Nov 06].

15. Atleast 22 Killed and 65 Injured from Train Collision: Available from: https://www.geo.tv/latest/119554-Several-hurt-as-twotrains-collide-in-Karachi. (Last accessed on 2016 Nov 6)

16. Pakistan Shah Noorani Shrine Bomb Kills 52” BBC. Available from: http://www.bbc.com/news/37962741. [Last accessed on 2016 Nov 12].

17. Ashkenazi I, Kessel B, Khashan T, Khashan T, Oren M, Haspel J, et al. Precision of in-hospital triage in mass-casualty incidents after terror attacks. Prehosp Disaster Med 2006;21:20-3.

18. Malik ZU, Hanif MS, Tariq M, Aslam R, Munir AJ, Zaidi H, et al. Mass casualty management after a suicidal terrorist attack on a religious procession in Quetta, Pakistan. J Coll Phys Surg Pak 2006;16:253-6.

19. Zafar H, Jawad A, Shamim MS, Memon AA, Hameed A, Effendi MS, et al. Terrorist bombings: Medical response in a developing country. J Pak Med Assoc 2011;61:561-6.

20. YouTube. Bomb blast in Karachi (Benazir’s Return). Available from: http://www.youtube.com/watch?v=Gq95MA2FB0o. [Last added on 2007 Oct 19].

21. Dawn News: KARACHI: ‘Lapses’ at Civil Hospital on Ashura Blast Day. Available from: http://www.dawn.com/wps/wcm/connect/dawn-contentlibrary/dawn/the-newspaper/local/karachi-lapses-at-civil-hospital-on-ashura-blast-day-410. [Last cited on 2010 Jan 04].

22. Jonathan LB, David H. Disaster Medicine. Philadelphia, PA: Wolters Kluwer Health/Lippincott Williams & Wilkins; 2007. p. 25.

23. Minhas MS, Mahmood K, Effendi J, Kumar R, Bhatti A. Terrorist bomb blasts: Emergency department management of multiple incidents. Trauma Int 2015;1:36-40.

24. Rehmani R. Disaster drill at a university hospital. J Pak Med Assoc 2005;55:28-32. 25. Anteau CM, Williams LA. The Oklahoma bombing-lesson learned. Crit Care Nurs Clin North Am 1997;9:231-6.

26. Ashkenazi I, Kessel B, Olsha O, Khashan T, Oren M, Haspel J, et al. Defining the problem, main objective, and strategies of medical management in masscasualty incidents caused by terrorist events. Prehosp Disaster Med 2008;23:83-9.

27. Leiba A, Blumenfeld A, Hourvitz A, Weiss G, Peres M, Laor D, et al. Lessons learned from cross-border medical response to the terrorist bombings in Tabba and Rasel-satan, Egypt, on 07 October 2004. Prehosp Disaster Med 2005;20:253-7.

How to Cite this article: Ali M Q, Muzzammil M, Batool Z, Minhas M S. Triage in Mass Casualty Incidents: Our Preparedness and Response – A Cross-sectional Study from a Tertiary Care Hospital, Karachi, Pakistan. Trauma International Sep-Dec 2018;4(2):6-10.

(Abstract Text HTML) (Download PDF)

A Prospective Study of Surgical Management of Bimalleolar Fractures with Various Modalities

September 10, 2018/in Volume 4 | Issue 2 | Sep-Dec 2018

Vol 4 | Issue 2 | Sept-Dec 2018 | page: 2-5 | Nandkishor B. Goyal, Sayyadshadab S. Jafri, Ashish Vinayak Patil, Aashish Babanrao Ghodke.

doi- 10.13107/ti.2018.v04i02.067

Author: Nandkishor B. Goyal [1], Sayyadshadab S. Jafri [1], Ashish Vinayak Patil [1], Aashish Babanrao Ghodke [1].

[1] Department of Orthopaedics, ACPMMC Dhule.

Address of Correspondence

Dr. Nandkishor B. Goyal,
Dr. Goyal Hospital, near Yellammuden Temple, Malegao, Dhule 424001.
Email: nandkishor596@gmail.com Dr. Nandkishor B.

Abstract

Ankle injuries should not be neglected because body weight is transmitted through it and locomotion depends on the stability of this joint. For this, we are conducting a prospective study of surgical management of bimalleolar fractures with various modalities. In our study, we surgically managed 36 patients and their functional assessment was done with Biard-Jackson scoring system. Excellent functional results are obtained with stable fixation of fractures. Tension band wiring was found to be better in internal fixation of medial malleolus as compared to screws fixation whereas lateral plating was best for fibular fractures. It was found that our results were coinciding with the literature.

Keywords: Biard-Jackson scoring, bimalleolar fractures, lateral plating, screw fixation, tension band wiring.

References

1. Marvin LS. Complication of fractures and dislocation of the ankle. In: EPPS, Charles H, editors. Complication in Orthopaedic Surgery. 3rd ed., Vol. 1. Ch. 23. Philadelphia, PA: J.B. Lippincott Company; 1994. p. 595-648.

2. Daly PJ, Fitzgerald RH Jr, Melton LJ, Ilstrup DM. Epidemiology of ankle fractures in Rochester, Minnesota. Acta Orthop Scand 1987;58:539-44.

3. Canale ST, Beaty JH. Campbell’s Operative Orthopaedics. 11th ed., Vol. 3. Philadelphia, PA: Mosby; 2008. p. 2043-66.

4. Burwell HN, Charnley AD. The treatment of displaced fractures at the ankle by rigid internal fixation and early joint movement. J Bone Joint Surg Br 1965;47:634-60.

5. Colton CL. The treatment of dupuytren’s fracture-dislocation of the ankle. J Bone Joint Surg Br 1971;53:63-71.

6. Desouza LJ. Fractures dislocations about the ankle. In: Gustilo RB, Kyle RF, Templeman D, editors. Fractures and Dislocations. Vol. 2. Ch. 30. St. Louis: Mosby Year Book Inc.; 1993. p. 997-1043.

7. Beris AE, Kabbani KT, Xenakis TA, Mitsionis G, Soucacos PK, Soucacos PN. Surgical treatment of malleolar fractures. A review of 144 patients. Clin Orthop Relat Res 1997;341:90-8.

How to Cite this article: Goyal N B, Jafri S S, Patil A V, Ghodke A B. A Prospective Study of Surgical Management of Bimalleolar Fractures with Various Modalities. Trauma International Sep-Dec 2018;4(2):2-5.

Half Sized Blog Element (Single Author Style)

Half Sized Blog Element (Multi Author Style)

Triage in Mass Casualty Incidents: Our Preparedness and Response – A Cross-sectional Study from a Tertiary Care Hospital, Karachi, Pakistan

A Prospective Study of Surgical Management of Bimalleolar Fractures with Various Modalities

Triage in Mass Casualty Incidents: Our Preparedness and Response – A Cross-sectional Study from a Tertiary Care Hospital, Karachi, Pakistan

A Prospective Study of Surgical Management of Bimalleolar Fractures with Various Modalities

Full Sized Blog Element (Big Preview Pic)

Triage in Mass Casualty Incidents: Our Preparedness and Response – A Cross-sectional Study from a Tertiary Care Hospital, Karachi, Pakistan

Author: Muhammad Qasim Ali [1], Muhammad Muzzammil [2], Zehra Batool [3], Muhammad Saeed Minhas [2].

Abstract

References

(Abstract Text HTML) (Download PDF)

A Prospective Study of Surgical Management of Bimalleolar Fractures with Various Modalities

Author: Nandkishor B. Goyal [1], Sayyadshadab S. Jafri [1], Ashish Vinayak Patil [1], Aashish Babanrao Ghodke [1].

Abstract

References

(Abstract Text HTML) (Download PDF)

Contact

Important Links

LICENSE